How to Get Both Medicare and Medicaid at the Same Time

You can have both Medicare and Medicaid, and the process depends on your age and disability status

Medicare and Medicaid are separate programs run by different federal agencies, but you can be enrolled in both at the same time. People who have both are called "dual may be able to access." Medicare is primarily for people 65 and older, regardless of income. Medicaid is for people with low income, and may be able to access rules vary by state. If you are 65 or older with low income, or if you are under 65 and disabled with low income, you may may have access to for both programs.

The enrollment path differs depending on your situation. If you are turning 65, you will enroll in Medicare through Social Security, and then you can apply for Medicaid through your state. If you are already on Medicaid and turn 65, Medicare becomes your primary insurance automatically when you reach 65. If you are under 65 and disabled, you may already be on Medicaid; you can enroll in Medicare once you have been receiving Social Security Disability Insurance (SSDI) for 24 months.

Key Takeaways

You can hold both Medicare and Medicaid at the same time if you meet income and age or disability requirements for both programs.
If you are 65 or older, you enroll in Medicare through Social Security; if you have low income, you then apply for Medicaid through your state.
If you are under 65 and disabled, you become may be able to access for Medicare after receiving SSDI for 24 months, and you can apply for Medicaid based on your state's income limits.
Your state Medicaid office determines whether you may have access to for Medicaid; income limits and covered services vary by state.
When you have both programs, Medicare pays first, and Medicaid covers costs Medicare does not pay, including some services Medicare does not cover.

How to enroll in Medicare when you are 65 or older

You must enroll in Medicare during your enrollment window, which begins three months before the month you turn 65 and ends three months after. The easiest way to enroll is online at Medicare.gov or by calling Social Security at 1-800-772-1213. You can also visit your local Social Security office in person. You will need your Social Security number and proof of citizenship or legal residency.

If you miss your initial enrollment window, you can still enroll, but you may face a permanent penalty on your Medicare Part B premium (the part that covers doctor visits). The penalty is 10 percent for each 12-month period you were may be able to access but did not enroll. Enroll as soon as you realize you missed the deadline to limit the penalty.

How to apply for Medicaid after enrolling in Medicare

Once you are enrolled in Medicare, you apply for Medicaid through your state. Each state runs its own Medicaid program, so the application process and income limits differ. You can find your state Medicaid office by visiting Medicaid.gov or calling 1-800-MEDICARE. Some states have online applications; others require you to apply in person or by mail.

You will need to provide proof of income (tax returns, pay stubs, or a Social Security statement), proof of residency, and proof of citizenship or legal residency. Income limits for Medicaid vary widely by state. In some states, the limit is 100 percent of the federal poverty level; in others, it is higher. Your state Medicaid office can tell you the exact limit and whether your income qualifies.

Processing time for Medicaid applications typically ranges from 30 to 45 days, though some states are faster. Once you are approved, coverage usually begins on the first day of the month in which you applied or the first day of the following month, depending on your state's rules.

How to get Medicare if you are under 65 and disabled

If you are under 65 and receiving SSDI, you become may be able to access for Medicare automatically after 24 months of receiving benefits. You do not need to apply; Medicare enrollment happens without action on your part. Your Medicare card will arrive in the mail about a month before your coverage begins.

If you are receiving Supplemental Security Income (SSI) instead of SSDI, the rules are different. SSI recipients can enroll in Medicare if they have been receiving SSI for 24 months or if they are also receiving SSDI. Contact Social Security at 1-800-772-1213 to confirm your may be able to access and enrollment status.

How to apply for Medicaid if you are under 65 and disabled

If you are under 65 and disabled, you may already be on Medicaid. Many people approved for SSDI or SSI are automatically enrolled in Medicaid in their state. Check your mail for a Medicaid card or contact your state Medicaid office to confirm whether you are already covered.

If you are not on Medicaid, you can apply through your state. Income limits for disabled adults vary by state but are often higher than limits for working-age adults without disabilities. Some states use the SSDI payment amount to determine Medicaid may be able to access; others look at your total household income. Your state Medicaid office can explain the specific rules that apply to you.

What happens when you have both Medicare and Medicaid

When you have both programs, they work together to pay your medical bills. Medicare is your primary insurance, meaning it pays first. Medicaid is secondary and covers costs that Medicare does not pay, including Medicare premiums, deductibles, and copayments. This combination is sometimes called "Medi-Medi" coverage.

Medicaid also covers some services that Medicare does not, such as long-term care in a nursing home, personal care services, and dental care (in some states). The exact services covered depend on your state's Medicaid program. When you see a doctor or go to the hospital, tell the provider that you have both Medicare and Medicaid so they bill correctly.

If you move to a different state, your Medicare coverage continues, but your Medicaid coverage ends. You must apply for Medicaid in your new state. Contact your new state's Medicaid office within 30 days of moving to avoid a gap in coverage.

Documents you will need for Medicare and Medicaid enrollment

The documents required differ between the two programs. For Medicare, you will need your Social Security number, proof of citizenship or legal residency (such as a birth certificate, passport, or naturalization papers), and proof of age. For Medicaid, you will need proof of income (tax returns, pay stubs, or a Social Security statement), proof of residency (such as a utility bill or lease), proof of citizenship or legal residency, and your Social Security number.

Keep copies of all documents you submit. If your application is denied or delayed, you may need to resubmit proof. Some states accept documents by mail; others require you to bring originals to an office. Ask your state Medicaid office which method they use before you send anything.

Frequently Asked Questions

Do I have to enroll in all parts of Medicare?

No. Medicare has four parts: Part A (hospital), Part B (doctor), Part D (prescription drugs), and Part C (Medicare Advantage). Part A is automatic at 65. You must actively enroll in Part B and Part D during your enrollment window or face penalties. Part C is optional and replaces Part A and B if you choose it.

What if my income is too high for Medicaid but I cannot afford Medicare premiums?

You may may have access to for a Medicare Savings Program (MSP), which is run by your state and helps pay Medicare premiums and cost-sharing. Income limits for MSP are higher than for Medicaid. Contact your state Medicaid office to learn whether you may have access to.

Can I lose Medicaid if my income increases?

Yes. If your income rises above your state's Medicaid limit, you will lose Medicaid coverage. Report income changes to your state Medicaid office within 30 days. Some states have a grace period before coverage ends; others end it immediately.

What if I am not a U.S. citizen?

Medicare requires proof of citizenship or legal residency. Medicaid rules for non-citizens vary by state. Some states cover lawfully present immigrants; others have restrictions. Contact your state Medicaid office to learn what documentation you need and whether you may have access to.

How do I know if I am already on Medicaid?

Check your mail for a Medicaid card, or call your state Medicaid office with your Social Security number. They can tell you whether you are enrolled and what services are covered under your state's plan.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.